We carried out this announced inspection on 31 January 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

Harold Smith Dental Practice is in Brandon, Suffolk and provides private treatment to adults and children.

There is level access to the reception area for people who use wheelchairs and those with pushchairs. The treatment room and waiting area are accessed via stairs. Car parking spaces, are available near the practice.

The dental team includes one dentist, one dental nurse, and two receptionists. The practice has one treatment room.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we collected 16 CQC comment cards filled in by patients and spoke with two other patients.

During the inspection we spoke with one dentist, one dental nurse, and two receptionists. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Thursday from 9am to 5pm. Friday from 9am to 4.30pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help it manage risk.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

There were areas where the provider could make improvements. They should:

• Review the availability of an interpreter service for patients who do not speak or understand English.

When we inspected this service on 17 May 2013 we had concerns about the standard of infection control and felt that systems were not fully protecting people from the risk of infection. We carried out this follow up inspection to check that improvements had been made and found that this was the case. This meant that there were systems in place to protect people from the risk and spread of infection.

We spoke with the dentist, the dental nurse and receptionist during the inspection. We also spoke with three people who used the service. They told us that they were happy with the service and trusted the dentist. One person had been attending the service for over 10 years and had arranged an emergency appointment that day. They told us “You don’t have to wait”. Another person said “It’s very friendly here” and told us that the dentist had treated their mother who lived in a nearby care home.

People told us that the dentist explained their proposed care and treatment to them in a way they understood and asked them about their medical history on each visit. We saw that people gave written consent to their treatment.Staff were supported, trained and experienced in their roles. There were procedures in place to ensure that equipment was properly maintained and serviced. We saw that the service had quality monitoring procedures in place.

We found that the decontamination room posed a potential infection risk because it was used to store items which did not relate to decontamination and because some infection control procedures were not being followed. We saw that this had not been picked up in the service’s own infection control monitoring.